Abstract:
OBJECTIVES:Lymphangiography and thoracic duct embolization are established treatments for post-surgical chylothorax. There is only limited experience in their application to treat post-surgical chylous ascites. A multi-center analysis of the technical and clinical success of lymphangiography and lymphatic interventions in the treatment of isolated, iatrogenic chylous ascites is reported. METHODS:21 patients (14 males; 7 females) aged 3-84 years (mean 56.9 years; median 63 years) were treated for isolated, iatrogenic chylous ascites between August 2012 and January 2018. Initial referrals occurred between 5-330 days (mean 72.7 days; median 40 days) after failing conservative therapy. Daily leak volumes ranged from 100 to 3000 mL. Lymphangiographic findings, techniques, clinical outcomes, and complications were recorded. RESULTS:21 patients underwent 29 procedures. Seven patients underwent multiple procedures after chylous ascites persisted. Bilateral nodal lymphangiography (NL) was technically successful in all (100%) patients. Lymphangiography identified a leak in 14/21 (67%) patients and in 16/29 procedures (55%). Ten procedures (34%) consisted of NL alone and one (3.4%) consisted of NL combined with lymphatic disruption (LD). Six procedures (21%) consisted of nodal glue embolization (NGE) while nine procedures (31%) were catheter-based lymphatic embolization. Three separate patients underwent three procedures (10%) consisting of balloon-occluded retrograde abdominal lymphatic embolization. Clinical success, defined as no additional drainage of chylous ascites at 15 days, was ultimately achieved in 18/21 patients (86%). There were no major or minor complications. CONCLUSION:Lymphatic interventions can successfully treat post-surgical chylous ascites. Given the low risk of procedural complication, early intervention is encouraged.
journal_name
Eur J Radioljournal_title
European journal of radiologyauthors
Majdalany BS,Khayat M,Downing T,Killoran TP,El-Haddad G,Khaja MS,Saad WAdoi
10.1016/j.ejrad.2018.10.019subject
Has Abstractpub_date
2018-12-01 00:00:00pages
41-47eissn
0720-048Xissn
1872-7727pii
S0720-048X(18)30369-3journal_volume
109pub_type
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journal_title:European journal of radiology
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journal_title:European journal of radiology
pub_type: 杂志文章,评审
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journal_title:European journal of radiology
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journal_title:European journal of radiology
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journal_title:European journal of radiology
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journal_title:European journal of radiology
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journal_title:European journal of radiology
pub_type: 杂志文章
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journal_title:European journal of radiology
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pub_type: 杂志文章,评审
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journal_title:European journal of radiology
pub_type: 杂志文章
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journal_title:European journal of radiology
pub_type: 杂志文章
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journal_title:European journal of radiology
pub_type: 杂志文章
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